🚀 go-pugleaf

OK, HERE IS MY RESPONSE.
QUESTION 1: (A) DOES THE PT. HAVE HX OF CIRRHOSIS? (B) HAS THE PT. BEEN 
DX W/D.M.?  (C) DOES THE PT. HAVE A TEMP? 
QUESTION 2: HIS HISTORY IS CERTAINLY AN IMPORTANT PART OF THE PE BUT I 
THINK THE SIGNS ARE WHAT ARE GOING TO LEAD TO THE DIAGNOSIS IN THIS CASE. 
SINCE HE DID HAVE A HIV TEST AT THE TB CLINIC THEN HIS RECORDS SHOULD BE 
OPBTAINED FROM THE CLINIC.
QUESTION 3:  WORKING ASSESMENT:  (1.) PORTAL HYPERTENSION SECONDARY TO 
LIVER DISEASE (PROBABLY CIRRHOSIS OR ALCOHOLIC HEPATITIS).
THIS ACCOUNTS FOR THE "HEMORRHOIDS" WHICH MAY NOT BE HEMORRHOIDS AT ALL. 
ADDITIONALLY, THE LIVER DISEASE ACCOUNTS FOR THE TESTICULAR ATROPHY. (2.) 
 NEXT ON MY LIST WOULD INCLUDE PORTAL SYSTEMIC ENCEPHALOPATHY.  THIS 
WOULD ACCOUNT FOR ABOVE SIGNS AND ALSO THE "FOUL" BREATH.  (3)  OTHER 
CAUSES MAY BE OTHER DISORDERS OF THE LIVER INCLUDING ALCOHOLIC HEPATITIS 
OR CIRRHOSIS.  (4)  THE PT MAY ALSO HAVE OTHER UNDERLYING ILLNESSES WHICH 
WOULD ACCOUNT FOR SIGNS SUCH AS THE BILATERAL RALES, ETC HOWEVER I FEEL 
THAT THE MOST OBVIOUS CAUSE WOULD BE LIVER-RELATED.
QUESTION 4: IN ADDITION TO OTHERS NAMED (1) LFT's (2) CHEM 
PANEL(INCLUDING LYTES) (3) DEPENDENT ON THE DEGREE OF THE NEUROLOGICAL 
SYMPTOMS, AN ECG MIGHT BE HELPFUL IF LOOKING TO R/O PORTAL SYSTEMIC 
ENCEPHALOPATHY (FOR WHICH THE LFT"s WOULDN'T HELP IN DX) (4) ALSO A UA 
MIGHT BE HELPFUL.

WELL, THAT IS MY 2 CENTS WORTH, WHAT DO YOU THINK?